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A modelling study of the budget impact of improved glycaemic control in adults with Type 1 diabetes in the UK

Research output: Contribution to journalArticlepeer-review

P. Choudhary, S. de Portu, A. Delbaere, J. Lyon, J. C. Pickup

Original languageEnglish
Pages (from-to)988-994
Number of pages7
JournalDiabetic Medicine
Issue number8
Early online date2 Feb 2019
Accepted/In press31 Jan 2019
E-pub ahead of print2 Feb 2019
Published1 Aug 2019

King's Authors


Aims: To develop a novel interactive budget impact model that assesses affordability of diabetes treatments in specific populations, and to test the model in a hypothetical scenario by estimating cost savings resulting from reduction in HbA 1c from ≥69 mmol/mol (8.5%) to a target of 53 mmol/mol (7.0%) in adults with Type 1 diabetes in the UK. Methods: A dynamic, interactive model was created using the projected incidence and progression over a 5-year horizon of diabetes-related complications (micro- and macrovascular disease, severe hypoglycaemia and diabetic ketoacidosis) for different HbA 1c levels, with flexible input of population size, complications and therapy costs, HbA 1c distribution and other variables. The model took a National Health Service and societal perspective. Results: The model was developed, and in the proposed hypothetical situation, reductions in complications and expected costs evaluated. Achievement of target HbA 1c in individuals with HbA 1c ≥69 mmol/mol (8.5%) would reduce expected chronic complications from 6.8 to 1.2 events per 100 person-years, and diabetic ketoacidosis from 14.5 to 1.0 events per 100 person-years. Potential cumulative direct cost savings achievable in the modelled population were estimated at £687 m over 5 years (£5,585/person), with total (direct and indirect) savings of £1,034 m (£8,400/person). Conclusions: Implementation of strategies aimed at achieving target glucose levels in people with Type 1 diabetes in the UK has the potential to drive a significant reduction in complication costs. This estimate may provide insights into the potential for investment in achieving savings through improved diabetes care in the UK.

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